Specialty News and Views: Refractive Management/Intervention - June 2006

The Specialty News and Views section represents the opinions of the contributing authors and does not imply endorsement by the American Academy of Ophthalmology. The Refractive Management/Intervention team members are: Tim Schneider, MD; Jorge Alio, MD; Penny Asbell, MD; Amit Chokshi, MD; Bradley Randleman, MD; and Gary Varley, MD.

Bioptics popularity is on the rise

As phakic IOLs and presbyopic IOLs become more commonly used, bioptics are also growing in popularity. For his research, Roberto Zaldivar of Buenos Aires used bioptics to overcome the shortcomings of phakic IOLs. For patients with high refractive errors, he implanted a phakic IOL, and any residual refractive error was corrected with secondary LASIK. The patient’s original refractive error was treated on 2 different optical planes (lenticular and corneal); thus, the technique was called “bioptics,” a term introduced by Dr. Zaldivar. Dr. Zaldivar achieved excellent short-term stability for up to 6 months of eyes treated with bioptics.

Now the scope of bioptics is being expanded to include pseudophakic eyes as well. As more and more patients have increased expectations about being able to go without eyeglasses, more keratorefractive procedures will be performed after both phakic and pseudophakic IOLs (multifocal and monofocal). Bioptics would be a useful technique to treat any errors in IOL calculation or to treat residual astigmatism, which is not possible with current phakic IOLs or multifocal IOLs.

In the future, advances in IOL technology may reduce the dependence on bioptics. Toric phakic IOLs and toric multifocal IOLs would decrease the need to treat residual astigmatism on the corneal plane. Also, the possibility of a laser-modified IOL would allow treatment of residual refractive errors at the IOL plane. Despite these advances, bioptics will likely play a role in treating a wide range of refractive errors.

REFERENCE

Schena LB. Bioptics update: correcting both lens and cornea. EyeNet. May 2006;37–40.

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